Nurse

• Provider Management
• Deputizing for the QA Head in Conflict resolution between enrollees and providers
• Vetting of Claims
• Negotiation and Re-negotiation of Tariffs
• Negotiation and Reconciliation of Bills
• Maintain managed care contracts
• Correspondence and liason with Health care providers in our network
• Plan, prepare, review and analyse data to identify trends and needs for improvement
• Monitoring of In and Out Patient record to prevent Fraud and Abuse.
• Manage call centre's line when required
• Marketing of Company Products
• Any other assigned duty.

Requirements

• Candidates should possess a Bachelor's Degree with 2 - 5 years work experience.